title: Clinicopathological features of tumors as predictors of the efficacy of primary neoadjuvant chemotherapy for operable breast cancer.
abstract: BACKGROUND
  Neoadjuvant chemotherapy (NC) is standard therapy for patients with locally advanced breast cancer and is increasingly used for early-stage operable disease. Clinical and pathological responses are important prognostic parameters for NC, which aims to achieve a pathological complete response or tumor reduction to reduce the volume of subsequent breast resection. Clinicopathological markers that predict patient response to NC are needed to individualize treatment.
  
  
  METHODS
  From 1998 to 2006, 368 patients with primary breast cancer underwent curative surgical treatment after NC (anthracycline and/or taxane without trastuzumab). We retrospectively evaluated the clinicopathological features and classification of the tumors using computed tomography (CT) before NC and analyzed the correlation with the pathological complete response (pCR) and reduction of tumor size after treatment.
  
  
  RESULTS
  The overall response and pCR rates in these patients were 86% and 17%, respectively. In multivariate analysis, classification as a scirrhous-type tumor was an independent predictor of reduced likelihood of pCR (p=0.0115; odds ratio 0.21). For tumor reduction, histological grade 3 (p=0.0002; odds ratio 3.3) and localized tumors identified by using CT imaging (p=0.0126; odds ratio 2.4) were independent predictors in multivariate analysis.
  
  
  CONCLUSIONS
  In this study, NC often did not result in pCR for breast cancers classified as scirrhous. Furthermore, tumor type classification using CT imaging and histological grading was effective to predict tumor reduction in response to NC that included an anthracycline and/or a taxane.
authors.affiliation: Department of Surgery, National Cancer Center Hospital, Tokyo, Japan. tshien@md.okayama-u.ac.jp
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Shien
authors.forename: Sadako
authors.initials: S
authors.lastname: Akashi-Tanaka
authors.forename: Kunihisa
authors.initials: K
authors.lastname: Miyakawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Hojo
authors.forename: Chikako
authors.initials: C
authors.lastname: Shimizu
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Seki
authors.forename: Masashi
authors.initials: M
authors.lastname: Ando
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kohno
authors.forename: Naruto
authors.initials: N
authors.lastname: Taira
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Doihara
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Katsumata
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kinoshita
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy / Q000379:methods*; D017239:Paclitaxel / Q000008:administration & dosage; D011237:Predictive Value of Tests; D012074:Remission Induction; D012189:Retrospective Studies; D013629:Tamoxifen / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D013629:Tamoxifen; D015251:Epirubicin; D004317:Doxorubicin; D003520:Cyclophosphamide; D017239:Paclitaxel; D005472:Fluorouracil